Diagnosis of Heart Failure in Chronic Obstructive Pulmonary Disease Using the Lung Ultrasound

• Conditions: Dyspnea; Decompensated Heart Failure ; COPD Exacerbation
• Interventions: Diagnostic Test: calculate LUS score

• Registration Number: NCT05352490
• Lead Sponsor: University of Monastir

Brief Summary

Acute Heart failure (AHF) is a common cause of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). This association is frequently underestimated with regard to the difficulty of clinical diagnosis. The investigators expect that the application of the lung ultrasound could be useful in this issue.

Detailed Description

Chronic obstructive pulmonary disease (COPD) is a frequent disease in our population affecting mainly the elderly and males. Dyspnea is the most common reason for consultation for patients with COPD in ED. Distinguishing between pulmonary and/or cardiac origin can be challenging.Physical examination, laboratory findings and radiography are imperfect. Lung ultrasound sonography (LUS) has recently gained a large place in the diagnosis of heart failure (HF), but its contribution to the diagnosis of HF in COPD remains poorly studied.

Purpose: The purpose of this study is to assess the contribution of LUS in the diagnosis of HF in COPD patients with acute dyspnea

. Physical examination, laboratory findings and radiography are imperfect, resulting in a need for sophisticated test results that delay management. Lung ultrasonography is becoming a standard tool in critical cases in the ED. the investigators aim to perform ultrasonography on COPD patients admitted to the ICU with dyspnea, comparing lung ultrasonography results on initial presentation with the final diagnosis by the ICU team. Three items were assessed: artifacts (horizontal A lines or vertical B lines indicating interstitial syndrome), lung sliding, and alveolar consolidation and/or pleural effusion, these items were grouped to assess ultrasound profiles. This study assesses the potential of lung ultrasonography to diagnose heart failure.The second aim of this study was to evaluate the inter-observer reproducibility of LUS performed by ED residents in the evaluation of cardiac causes of acute dyspnea.This study includes patients with COPD consulting for acute dyspnea. We performed a lung ultrasound on all patients included. The diagnosis of heart failure (HF) was based on clinical, radiological, cardiac-ultrasound and expert data. The LUS diagnostic performance indicators were calculated using the different cut-off proposed by the LUS score.Then the probability of AHF was defined as : low probability (LUS\<15) intermediate probability (15≤ LUS\<30), and high probability (LUS≥30 ).

Study Timeline

• Study Start: 2022-03-01
• Study First Submitted: 2022-03-09
• Study First Submitted QC: 2022-04-22
• Study First Posted: 2022-04-28
• Status Verified: 2022-08
• Last Update Submitted: 2022-08-06
• Last Update Posted: 2022-08-09
• Primary Completion: 2023-05
• Study Completion: 2023-05

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 350

Inclusion Criteria

• patients with history of COPD admitted to the emergency department for dyspnea non traumatic dyspnea

Exclusion Criteria

• instable hemodynamic or neurological status non consent to participate in the study

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
HF-group	calculate LUS score	patients with AECOPD and acute heart failure
non HF-group	calculate LUS score	patients with AECOPD without acute heart failure

Primary Outcome Measures

Name	Time	Method
the accuracy of LUS in the diagnosis of heart failure in COPD patients	1day	the accuracy of LUS in the diagnosis of heart failure in patients with COPD measured by area under the roc curve
LUS in COPD patients whith pulmonory echography	1day	LUS measured whith pulmonory echography by the number of lines A and B.

Trial Locations

Locations (1)

Emergency Departement; 🇹🇳 Monastir, Tunisia